[Congressional Record Volume 162, Number 108 (Wednesday, July 6, 2016)]
[Extensions of Remarks]
[Pages E1038-E1040]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                               H.R. 5456

                                 ______
                                 

                           HON. VERN BUCHANAN

                               of florida

                    in the house of representatives

                        Wednesday, July 6, 2016

  Mr. BUCHANAN. Mr. Speaker, I submit the following extraneous 
materials on H.R. 5456, the Family First Prevention Services Act of 
2016:

                                      Alliance for Strong Families


                                              and Communities,

                                    Washington, DC, June 14, 2016.
     Hon. Kevin Brady, Chair,
     House of Representatives,
     Ways and Means Committee.
     Hon. Vern Buchanan, Chair,
     House of Representatives,
     Human Resources Subcommittee.
     Hon. Orrin Hatch, Chair,
     U.S. Senate,
     Senate Finance Committee.
     Hon. Sander Levin, Ranking Member,
     House of Representatives,
     Ways and Means Committee,
     Hon. Lloyd Doggett, Ranking Member,
     House of Representatives,
     Human Resources Subcommittee.
     Hon. Ron Wyden, Ranking Member,
     U.S. Senate,
     Senate Finance Committee.
       Dear Chairman Brady and Ranking Member Levin, Chairman 
     Buchannan and Ranking Member Doggett, and Chairman Hatch and 
     Ranking Member Wyden: The Alliance for Strong Families and 
     Communities thanks you for your leadership and for 
     introducing the Family First Prevention Services Act of 2016. 
     The legislation promotes numerous policy priorities that are 
     consistent with our network's guiding principles for 
     improving child and family safety, permanency and well-being.
       We appreciate efforts you have made to address past 
     concerns and to include components that are informed by 
     effective practices in states and localities, technology 
     updates, and current research. These include:
       Permitting the use of federal funds to pay for programs 
     across the evidence-based spectrum, and to continue knowledge 
     formation in what works;
       Making Title IV-B funds available to states so that they 
     may modernize their Interstate Compact on the Placement of 
     Children (ICPC) services so that so that children may be more 
     quickly and effectively placed in appropriate homes across 
     state lines;
       Supporting the National Commission to Eliminate Child Abuse 
     and Neglect Fatalities' recommendation that a 21st Century 
     Child Welfare system require states to develop a statewide 
     plan to prevent child abuse and neglect fatalities;
       Requiring the use of an age-appropriate, evidence-based, 
     validated needs assessment to help determine a child's need 
     for behavioral health support through a therapeutic 
     residential treatment setting; and
       Engaging families in a child's residentially-based trauma-
     informed behavioral health treatment to strengthen the 
     likelihood of their success, including establishing a family 
     and permanency team in the initial needs assessment and 
     ongoing progress monitoring.
       We are very pleased with the bipartisan, bicameral effort 
     to address child welfare reforms, and specifically, the 
     longstanding policy priority to expand Title IV-E for 
     prevention so that children and parents/caregivers may have 
     access to services and interventions that ensure child safety 
     and build family stability.
       While the Alliance enthusiastically supports the Family 
     First Prevention Services Act of 2016, we do believe we have 
     identified a significant technical misalignment within the 
     definition of the Qualified Residential Treatment Program 
     (QRTP) that, if addressed, would strengthen the bill, 
     increase its effectiveness and mitigate against what we 
     believe to be unintended consequences for children to whom we 
     want to receive the right treatment, at the right time in the 
     most appropriate setting. We fully support the requirement 
     for a QRTP to use a trauma-informed treatment model, but are 
     concerned about the rigid aspects of the language for QRTP 
     staffing. The prescription of nursing and clinical staff 
     being onsite during business hours is not consistent with 
     Congress' desire to use evidence in its requirements on 
     states and moves further away from a system that is child- 
     and family-centered and community-based. We believe that 
     QRTPs must abide by the fidelity elements of the approved, 
     trauma-informed treatment model that they elect to use in 
     accordance with the requirements in the bill and that the 
     current language regarding staffing is inconsistent with the 
     bill's treatment model requirement.
       For example, if the fidelity elements of the selected 
     treatment model require licensed or registered nurses to be 
     onsite during business hours and available 24/7, then a QRTP 
     must meet that requirement. Likewise, if fidelity to an 
     approved model requires a different staffing composition and 
     pattern, then the QRTP must meet that model's requirements 
     and needs the flexibility to do so.
       Therefore, rather than requiring the staff to be onsite 
     during business hours, we recommend an amendment that aligns 
     the treatment model requirement with the staffing 
     requirement. The amendment would require staff to be onsite 
     according to the trauma-informed treatment model being used 
     by the QRTP. Our commonsense amendment acknowledges that high 
     quality trauma-informed treatment models prescribe staffing 
     patterns that are designed to achieve the outcomes proven by 
     the program model. And, it strengthens the bill's 
     effectiveness toward the greatest chance of success and 
     normalcy for children provided in the most family-like 
     settings possible.
       The Alliance's wholehearted support of the Family First 
     Prevention Services Act of 2016 is unqualified and not 
     contingent upon inclusion of the recommended amendment but, 
     if the bill is passed without this amendment we intend to 
     work to build a coalition to change this aspect of the QRTP 
     requirements prior to implementation of these provisions in 
     Title II in 2019.
       Thank you very much for your hard work. We look forward to 
     working with you and encourage you to contact Marlo Nash, 
     Senior Vice President of Public Policy and Mobilization with 
     questions or to request additional information.
           Sincerely,
                                                    Susan Dreyfus,
     President and CEO.
                                  ____


   AAP Statement Supporting the Family First Prevention Services Act

 [6/13/2016 by Benard P. Dreyer, MD, FAAP, president, American Academy 
                             of Pediatrics]

       ``The American Academy of Pediatrics (AAP) commends House 
     Ways and Means

[[Page E1039]]

     Committee Chairman Kevin Brady (R-Tex) and Ranking Member 
     Sander Levin (D-Mich) and Senate Finance Committee Chairman 
     Orrin Hatch (R-Utah) and Ranking Member Ron Wyden (D-Ore) for 
     releasing the Family First Prevention Services Act of 2016. A 
     comprehensive bipartisan effort to improve how the child 
     welfare system serves children and families in adversity. 
     This bill represents a pivotal opportunity for a major 
     federal policy shift that moves away from placing children in 
     out-of-home care and toward keeping families together.
       ``Children in or at-risk for entering foster care are 
     especially vulnerable, they are more likely to be exposed to 
     trauma and often have complex medical needs. This bill not 
     only recognizes the unique needs of children and families in 
     adversity, but also makes great strides to meet them in a way 
     that pediatricians can stand behind through evidence-based, 
     prevention-focused approaches. The bill offers states much-
     needed federal funding to support mental health, substance 
     abuse and in-home parenting skills programs for families of 
     children at-risk of entering foster care. This policy rewards 
     state efforts to preserve and strengthen families by 
     providing federal funds to administer prevention programs in 
     a way that is steeped in science.
       ``Children fare best when they are raised in families 
     equipped to meet their needs. Congregate care, when 
     necessary, should be of high-quality for the shortest 
     possible duration and reserved for instances in which it is 
     absolutely essential. The AAP supports the bill's emphasis on 
     ensuring that children are only placed in a non-family 
     setting if they have a demonstrated need for the services 
     available in that setting. The AAP also appreciates that 
     congregate care facilities must be accredited and have 
     licensed clinical and nursing staff to ensure they are 
     capable of caring for vulnerable children and meeting their 
     complex health needs.
       ``Fixing the shortcomings in our child welfare system will 
     require continued investment across both state and federal 
     governments. The Family First Prevention Services Act does 
     just what its name says. It puts families first. This bill 
     represents major, meaningful progress toward protecting 
     children and supporting their families in creating safe and 
     stable homes. Pediatricians look forward to continuing to 
     walk alongside bipartisan members of Congress to advance the 
     bill toward a vote as soon as possible.''
       ###
       The American Academy or Pediatrics is an organization of 
     64,000 primary care pediatricians, pediatric medical 
     subspecialists and pediatric surgical specialists dedicated 
     to the health, safety and well-being of infants, children, 
     adolescents, and young adults. For more information visit 
     www.aap.org and follow us on Twitter @AmerAcadPeds.
                                  ____



                                     American Bar Association,

                                                    June 20, 2016.
     Subject: Family First Prevention Services Act of 2016

     Hon. Kevin Brady,
     Chairman, Committee on Ways and Means, House of 
         Representatives.
     Hon. Vern Buchanan,
     Chairman, Human Resources Subcommittee, Committee on Ways and 
         Means, House of Representatives.
     Hon. Sandy Levin,
     Ranking Member, Committee on Ways and Means, House of 
         Representatives.
     Hon. Lloyd Doggett,
     Ranking Member, Human Resources Subcommittee, Committee on 
         Ways and Means, House of Representatives.
       Dear Representative: On behalf of the American Bar 
     Association, with nearly 400,000 members, I write in support 
     of H.R. 5456, the Family First Prevention Services Act of 
     2016. The ABA has consistently advocated for policies that 
     address key services and support for families involved in the 
     child welfare system. We support reform of the federal child 
     welfare financing structure to end fiscal incentives when 
     placing children in foster care at the expense of providing 
     services that can keep children and families safely together, 
     and we also advocate for the reduction of the use of 
     congregate residential care settings as a long-term 
     placement.
       The Family First Prevention Services Act takes crucial 
     steps toward achieving these goals. Allowing use of federal 
     child welfare funds under Title IV-E of the Social Security 
     Act for preventive investments will benefit children and 
     families tremendously by providing opportunities for children 
     to remain in their homes or with kin caregivers while needed 
     supports and services are provided. Additionally, the 
     legislation's focus on ensuring that children entering foster 
     care are placed in the least restrictive, most appropriate 
     family-like setting supports children's well-being immensely.
       Additional provisions of the legislation significantly 
     support vulnerable children and families, including:
       Extended funding for Court Improvement Program (CIP) 
     Grants. Courts play an essential role in ensuring safety and 
     permanency for abused and neglected children, and CIP funds 
     have had a great impact on the child welfare system, serving 
     as a catalyst for essential judicial system reform.
       Extended funding for Title IV-B of the Social Security Act, 
     Subparts 1 and 2. The Stephanie Tubbs Jones Child Welfare 
     Services Program and the Promoting Safe and Stable Families 
     Program provide vital support to states' efforts to protect 
     and serve families, both by supporting immediate preventive 
     services while children remain at home and funding 
     reunification services so that children can be safely 
     returned home in a timely manner. The legislation's 
     elimination of the time limit on reunification services under 
     Title IV-B is a particularly important change, as it will not 
     only allow families to benefit from services for longer 
     periods of time, but will also make more families eligible 
     for those services.
       Identification of model licensing standards for relative 
     foster family homes. Model licensing standards will help 
     address barriers to licensure that relative caregivers face. 
     Flexible standards will help ensure children are placed in 
     safe and appropriate homes, while promoting the opportunity 
     for more relatives and non-related caregivers to become 
     foster parents.
       Providing a 50% federal match for evidence-based Kinship 
     Navigator programs. These programs have provided critical 
     services and information to support kinship care providers as 
     they navigate multiple, complex systems while caring for 
     children.
       Expanded access and other improvements to the John E. 
     Chafee Foster Care Independence Program. All current and 
     former youth in foster care have a right to quality 
     education, and these provisions provide additional resources 
     to help youth successfully transition to adulthood.
       In addition, evaluations of existing high quality legal 
     representation programs for parents, children and 
     caregivers--including representation prior to the child's 
     removal--have shown that investment made in these services 
     results in improved systemic functioning: more families 
     receive individualized services, fewer children suffer the 
     trauma of unnecessary removals, children removed from home 
     return sooner and with fewer disruptions, and taxpayer 
     dollars are saved.
       We thank you for your leadership on this important 
     legislation and we stand ready to assist you with moving it 
     forward. Should you have any questions or want additional 
     information concerning our comments, please contact David 
     Eppstein, Legislative Counsel, ABA Governmental Affairs 
     Office or Robert Horowitz, Interim Director, ABA Center on 
     Children and the Law.
           Sincerely,
     Thomas M. Susman.
                                  ____

                                                   American Public


                                   Human Services Association,

                                                    June 14, 2016.
     Hon. Kevin Brady, Chair, House of Representatives,
     Ways and Means Committee.
     Hon. Vern Buchanan, Chair, House of Representatives,
     Human Resources Subcommittee.
     Hon. Orrin Hatch,
     Chair, U.S. Senate,
     Senate Finance Committee.
     Hon. Sander Levin,
     Ranking Member, House of Representatives,
     Ways and Means Committee.
     Hon. Lloyd Doggett,
     Ranking Member, House of Representatives, Human Resources 
         Subcommittee.
     Hon. Ron Wyden,
     Ranking Member, U.S. Senate,
     Senate Finance Committee.
       Dear Chairman Brady and Ranking Member Levin, Chairman 
     Buchannan and Ranking Member Doggett, and Chairman Hatch and 
     Ranking Member Wyden: The American Public Human Services 
     Association (APHSA) and its affiliate, the National 
     Association of Public Child Welfare Administrators (NAPCWA), 
     on behalf of most of our state and local public child welfare 
     administrators offer our support for the Family First 
     Prevention Services Act of 2016 (H.R. 5456) and thank you for 
     your leadership in introducing the bill. The legislation 
     promotes a number of policy priorities our state and local 
     members have identified as key to improving child and family 
     well-being. These policies are part of APHSA's Pathways 
     Initiative, a broader framework for building a stronger, more 
     sustainable human-services system. Under Pathways, we are 
     working with our members to promote more integrated policies 
     (illustrated in the bill's alignment of federal funds across 
     the Title IV-E and IV-B programs); invest in outcomes 
     (through the new Title IV-E foster care prevention program 
     that provides funding for agencies to intervene earlier with 
     families and decrease the need for placement in out-of-home 
     settings); partnering for collective impact (addressed in the 
     reauthorized Regional Partnership Grants) and others.
       Additionally, we appreciate the efforts you have made to 
     address past concerns raised by our state and local public 
     child welfare leaders. These include:
       Permitting the use of federal funds to pay for programs 
     across the evidence-based spectrum, to support promising 
     practices and build knowledge about what works;
       Making Title IV-B funds available to states so that they 
     may modernize their Interstate Compact on the Placement of 
     Children (ICPC) services so children may be more quickly and 
     effectively placed in appropriate homes across state lines;
       Expanding parental substance abuse treatment through foster 
     care maintenance payments for children with parents in a 
     licensed residential family-based treatment facility;
       Supporting the National Commission to Eliminate Child Abuse 
     and Neglect Fatalities recommendation for states to develop a 
     statewide plan to prevent fatalities resulting from cases of 
     child abuse and neglect;
       Expanding the John H. Chafee Foster Care Independence 
     Program for foster youth to age 23 and extending the 
     educational training vouchers for youth to age 26; and

[[Page E1040]]

       Other measures that guide out-of-home non-foster family 
     placements, maintain services and programs for children and 
     families, and incentivize permanency through adoption and 
     guardianship placements.
       We appreciate your bipartisan, bicameral effort to address 
     child welfare reform, and specifically, the longstanding 
     policy priority to expand Title IV-E for prevention so that 
     children and parents/caregivers have access to services and 
     interventions that maintain family stability. While the bill 
     presents an unprecedented opportunity and many of our key 
     leaders have shared their perspectives and concerns with 
     Committee staff, some members will need to fully examine and 
     understand the implications of each Title and section on 
     their states and localities. We will continue to monitor and 
     assess the impact of each Title and section to identify and 
     share with you any unintended consequences. With Congress' 
     support, we can help to ensure that all children and families 
     can develop and live to their full potential.
       Again, thank you very much for your hard work. We look 
     forward to working with you and encourage you to contact 
     Christina Crayton, Assistant Director, Policy and Government 
     Affairs with questions or to request additional information.
           Respectfully submitted,
     Tracy Wareing Evans,
       Executive Director, American Public Human Services 
     Association.
     Julie Krow,
       President, National Association of Public Child Welfare 
     Administrators,
       Deputy Executive Director, Community Partnerships, Colorado 
     Department of Human Services.
                                  ____



                                  Children and Family Futures,

                                                    June 13, 2016.
     Hon. Kevin Brady,
     Chairman, Committee on Ways and Means,
     House of Representatives.
     Hon. Orrin Hatch,
     Chairman, Committee on Finance,
     U.S. Senate.
     Hon. Vern Buchanan,
     Chairman, Human Resources Subcommittee, Committee on Ways and 
         Means, House of Representatives.
     Hon. Sandy Levin,
     Ranking Member, Committee on Ways and Means, House of 
         Representatives.
     Hon. Ron Wyden,
     Ranking Member, Committee on Finance,
     U.S. Senate.
     Hon. Lloyd Doggett,
     Ranking Member, Human Resources Subcommittee, Committee on 
         Ways and Means, House of Representatives.
       Dear Ways and Means and Senate Finance Committee Chairmen 
     Brady and Hatch, Ranking Members Levin and Wyden and Human 
     Resources Subcommittee Chairman Buchanan and Ranking Member 
     Doggett: On behalf of Children and Family Futures, I am 
     pleased to share our support for the Family First Prevention 
     Services Act (H.R. 5456) introduced today by House Ways and 
     Means Human Resources Subcommittee Chairman Vern Buchanan (R-
     FL) and joined by eleven other bi-partisan original co-
     sponsors.
       Children and Family Futures, a national nonprofit 
     organization based in Lake Forest, California, has more than 
     20 years of experience in improving outcomes for children at 
     the intersection of child welfare and substance use disorder 
     treatment agencies and family courts. We recently had the 
     opportunity to testify at Senate Finance and Senate Homeland 
     Security and Governmental Affairs Hearings on the effects of 
     opioids on our nation's child welfare agencies. As you may 
     know, there are 8.3 million children--almost 11% of America's 
     children--who live with a parent who is alcoholic or needs 
     treatment for illicit drug abuse. About two-thirds of the 
     children who enter the child welfare system are affected by 
     parents with substance use disorders, and when we ask 
     children and youth in foster care what they need the most, 
     they often ask for substance abuse treatment for their 
     parents so that their family can stay together. Quality 
     substance abuse prevention and treatment is one of the 
     cornerstones of a strong and effective child welfare system.
       H.R. 5456 takes several critical steps to ensure that 
     parents and children receive the full range of supportive 
     services they need to heal and thrive. By allowing federal 
     IV-E dollars to be used in a time-limited way for evidence-
     based prevention services, including mental health, substance 
     abuse prevention and in-home skill-based programs, the 
     proposed legislation provides an unprecedented opportunity 
     for child welfare agencies to expand the services parents 
     need to continue to care for their children safely without 
     unnecessary foster care placements.
       In addition, allowing states to draw down Title IV-E foster 
     care maintenance payments on behalf of children who are 
     placed in residential family treatment settings with a parent 
     who is receiving treatment is another effective way to ensure 
     that families can stay together while getting the services 
     and supports they need to get back on their feet. For 
     children whose parents struggle with alcohol and illicit drug 
     abuse, the elimination of the time limit to allow family 
     reunification services to be provided to any child in foster 
     care and for up to 15 months after a child is reunited with 
     his or her biological family will allow children of parents 
     who are still in the very first stages of recovery to get the 
     ongoing help they need to maintain both stability and 
     sobriety.
       CFF also strongly supports H.R. 5456's reauthorization of 
     the Regional Partnership Grant program that provides funding 
     to state and regional grantees seeking to provide evidence-
     based services to prevent child abuse and neglect related to 
     substance abuse and revised grant requirements based on 
     lessons learned from the most effective past grants. In 
     addition to updating the program to specifically address the 
     opioid and heroin epidemic, the proposal legislation 
     leverages what has been learned to ensure that new foster 
     care prevention funding provided under the bill is used 
     effectively.
       In addition to providing much-needed attention to 
     prevention services for children and families who come to the 
     attention of the child welfare system, the legislation's 
     provisions to reduce the over-reliance on group care 
     facilities are an equally important step in supporting 
     children and keeping families together. The legislation's 
     current approach to reducing unnecessary care while enhancing 
     the protections and oversight for Qualified Residential 
     Treatment Programs (QRTP) will ensure that young people who 
     are struggling with their own substance use disorder or 
     mental health issues have full access to clinically 
     appropriate residential treatment options and that a 
     continuum of quality services are available to help them 
     transition back home to their families. Moreover, improving 
     and expediting an effective assessment process and increasing 
     judicial oversight of placement decisions on an ongoing basis 
     also represent significant progress in connecting young 
     people with the right services on a timely basis while also 
     maintaining positive family and community connections.
       Untreated substance use disorders are among the most 
     critical and devastating crises facing the nation's children 
     and families. Thanks to the leadership and bipartisanship 
     demonstrated by members of the House Ways and Means and 
     Senate Finance Committees, H.R. 5456 offers a range of 
     innovative solutions designed to keep children and families 
     together and provide the services and supports they need to 
     lead healthy and productive lives. We are deeply appreciative 
     of your collective work on this bill and are confident that, 
     if passed, it will continue to help thousands children and 
     families, now and for years to come.
           Sincerely,
                                                   Nancy K. Young,
                                                  Ph.D., Director.
                                                Sidney L. Gardner,
     M.P.A., President.

                          ____________________